HTLV-I INFECTION AMONG PROSTITUTES AND PREGNANT-WOMEN IN KINSHASA, ZAIRE - HOW IMPORTANT IS HIGH-RISK SEXUAL-BEHAVIOR

High-risk sexual behavior as risk factor for human T-cell lymphotropic virus type I (HTLV-I) infection was assessed in cross-sectional studi es with 1,183 prostitutes and 1,166 pregnant women in Kinshasa, Zaire. Eighty six (7.3%) prostitutes were positive for HTLV-I. The seropreva lence among prostitutes from the regions along the equator was 12.7%, whereas among prostitutes from the other regions it ranged between 0 a nd 4.3%. In the prostitutes from the high-prevalence regions, but not in the prostitutes from the low-prevalence regions, HTLV-I infection w as associated with increasing age [odds ratio (OR) = 1.1 per year incr ement], active syphilis (OR = 2.3), and human immunodeficiency virus ( HIV) infection (OR = 2.0). Forty three (3.7%) pregnant women were HTLV -I seropositive. Among the women from low-prevalence regions, there wa s no significant difference in HTLV-I seroprevalence between prostitut es (4.3%) and pregnant women (3.5%). In a group of 409 prostitutes who were observed for a mean duration of 23 months, the incidence of HTLV -I infection was 0.7 per 100 women-years, whereas the incidence of HIV infection was 9.8 per 100 women-years. We conclude that in Kinshasa p rostitution per se was not associated with an increased risk of HTLV-I infection.